Jak Inhibitor: The New Treatment Option For Those With Hair Loss

If you or someone you know is struggling with severe alopecia areata, you may have heard of Olumiant by now. In essence, Olumiant is a prescription FDA-approved once-daily pill used to treat this condition.¹

What is alopecia areata

Alopecia areata may occur when your immune system destroys the hair follicles. Losing hair in patches is a symptom of this. Sometimes, these patches might unite and then stand out more.²

Alopecia areata can start in adolescence or later in life, something that varies from person to person. Such hair loss is quite prevalent in the world and may impact persons of any age, sex, or ethnicity.¹

Other autoimmune conditions such as thyroid disease, vitiligo, lupus erythematosus, and psychiatric disorders like anxiety and depression are linked to alopecia areata. The course of alopecia areata, a chronic condition that can be unpredictable and varied, might change over time and include relapses, remissions, or the continuation of significant hair loss.³

JAK inhibitors prevent JAK enzyme activity, disrupt the JAK-STAT signalling pathway, and stop certain cytokines’ downstream signalling, hence why JAK inhibitors are a newly available alopecia areata therapy option.⁴

How Olumiant works

The immune-modulating drug called a Janus kinase inhibitor, also called a JAK inhibitor, works by inhibiting the activity of one or more Janus kinase family enzymes, which then affects the JAK-STAT signalling cascade in lymphocytes.⁴

Olumiant is an intracellular Janus kinase (JAK) inhibitor. It is believed to interfere with an immunological signalling mechanism that has a role in alopecia areata. It should be taken once a day as a 2mg pill or a 4mg pill for those who have not achieved the desired effect with a regular dosage after more than two months or so.

Before taking a JAK inhibitor like Olumiant, you should undergo the following blood tests:

Hepatitis B screening
Lipid profile
Renal profile
Liver profile
Full blood count
Quantiferon TB gold
Hepatitis C antibody Anti-HCV

In addition to the blood tests mentioned above, a chest X-ray will need to be done.

If you have any symptoms while taking Olumiant, such as a rash (hives), breathing difficulties, faintness or dizziness, or inflammation of your tongue, throat, or lips, refrain from taking any more Olumiant and seek emergency medical attention immediately.

Monitoring and treatment adjustment

Upon completion of the aforementioned tests, patients who take Olumiant will need to be monitored. Their lipid parameters will be tested at week 12, and patients will be managed according to International clinical guidelines if they have hyperlipidaemia.

After three months, any further lab monitoring will be done in accordance with routine patient management.

Safety

Those who take Olumiant should be aware that it may cause severe side effects, including infections caused by fungi, bacteria, or viruses (tuberculosis or shingles, for example).¹

Olumiant can make patients more susceptible to infections or worsen existing infections – hence why testing for TB before you start treatment is so critical. If you have an infection, refrain from beginning Oluminant until you have a doctor’s approval.¹

If you are undergoing the treatment but start to feel an infection coming on, inform a doctor right away. The signs of infection are muscle aches, fever, chills, sweating, wheezing, bloody phlegm, excessive weight loss, body sores, stomach problems, diarrhoea, burning sensations when urinating, and overwhelming tiredness. If you register any of these symptoms, you must refrain from continuing the medication until your condition is managed.¹

Those above the age of 50 who have one or more heart disease risk factor(s) and are taking JAK inhibitors also may have certain cardiovascular events. This is often attributed to the fact that they are more likely to have blood clots in the veins of their lungs or legs and arteries – a life-threatening condition. In other cases, they may even experience a heart attack or a stroke, especially if they are or used to be a smoker. In these cases, patients should stop taking Oluminant and immediately seek medical attention.¹

Some people on Olumiant also experience allergic reactions. Stop taking Olumiant and seek immediate medical assistance if you experience any symptoms, including rash (hives), difficulty breathing, feeling faint or disoriented, or swelling of your tongue, lips, or neck.¹

If a patient also takes methotrexate, anti-inflammatory drugs, or corticosteroids alongside Oumiant, you are liable to find tears in the stomach or intestines. You can tell this has occurred if you have severe and persistent stomach pain, changed bowel habits, and a fever. Once the symptoms have been identified, you will need to visit a doctor to know how to proceed.¹

Your doctor should perform blood tests on you before and as you take Olumiant. If your red or white blood cell count is too low or if the results of your liver tests are abnormally high, you shouldn’t be using Olumiant. Depending on how these test results change, your doctor might decide to stop your Olumiant medication. At around 12 weeks, once you start taking Olumiant and whenever else is necessary, your doctor will need to examine your cholesterol levels.¹

Conclusion

Olumiant is an FDA-approved daily pill that can be taken by patients experiencing severe alopecia areata, a condition in which you lose your hair in patches. It is the first of its kind that has been FDA-approved for this indication. Olumiant works as a JAK inhibitor that halts the immunological signalling mechanism, often attributed to alopecia areata. However, it’s essential that you speak to your doctor to get all the necessary tests done before you undergo this treatment.

If you’re curious to learn more, visit Angeline Yong Dermatology, an established dermatology clinic in Singapore sub-specialising in medical and surgical hair loss. We are dedicated to the authentic, holistic, and personalised upkeep of all your dermatological needs. Contact us today.

References

What is Olumiant® for ALOPECIA AREATA: Olumiant® (baricitinib). What is Olumiant® for Alopecia Areata | Olumiant® (baricitinib). (2022, June 12). Retrieved November 30, 2022, from https://www.olumiant.com/alopecia-areata/what-is-olumiant

Cafasso, J. (2022, February 28). Everything you need to know about alopecia areata. Healthline. Retrieved November 30, 2022, from https://www.healthline.com/health/alopecia-areata#diagnosis

Lintzeri, D. A., Constantinou, A., Hillmann, K., Ghoreschi, K., Vogt, A., & Blume‐ Peytavi, U. (2022). Alopecia areata – current understanding and management. JDDG: Journal Der Deutschen Dermatologischen Gesellschaft, 20(1), 59–90. https://doi.org/10.1111/ddg.14689

Kontzias, A., Kotlyar, A., Laurence, A., Changelian, P., & O’Shea, J. J. (2012). Jakinibs: a new class of kinase inhibitors in cancer and autoimmune disease. Current opinion in pharmacology, 12(4), 464–470. https://doi.org/10.1016/j.coph.2012.06.008

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Jak Inhibitor: The New Treatment Option For Those With Hair Loss